Evaluation of a training program in domestic violence against children and adolescents for community health workers and nurses

Background: The Brazilian federal government established the Family Health Program (FHP) to improve access and quality of primary health care. Under a nurse’s supervision, groups of community health workers regularly visit families living in specific geographic areas, to identify and take action on different health and psychosocial problems. Because family violence is an issue every health worker will encounter in her or his work, it is extremely important their adequate preparation to deal properly with this subject. Objectives: To develop a training program in domestic violence against children and adolescents for community health workers and nurses, and to evaluate it’s impact on knowledge acquirement and attitude changing. Methods: A 27-hour training curriculum was developed by researchers including nine workshop sections (three-hour weekly meetings) based on interactive participation. Pairs of trained instructors (with a bachelor degree in psychology or social sciences) redelivered the training program to members of nine FHP units: seven in Embu city (southeast Brazil) and two in Fortaleza city (northeast Brazil). Impact evaluation strategies included self-report questionnaires completed by all participants (before and after the training program), and focus groups conducted three and six months after completing the workshops. Results: In total, 111 health-care professionals were trained: 75 from Embu and 36 from Fortaleza. Participants increased their ability to identify child abuse and to adequately fill out the notification form; acquired knowledge about intervention possibilities to interrupt family violence; and increased awareness about network possibilities involving local institutions that can offer support and protection to children and adolescents.